Thursday, 29 November 2012

Current antiretroviral therapy (ART) may lose its effectiveness in controlling the HIV epidemic

A study published in Epidemics reveals that drug resistance may lead to an increase in the number of people suffering from HIV.

There is an ongoing battle against HIV and AIDS worldwide, with an estimated 33.3 million people suffering from HIV globally. Many treatments to control HIV symptoms exist, however new research suggests that some of these may need to be reassessed. 

Antiretroviral therapy (ART) is currently the most efficient method in controlling the spread of HIV and is recommended as the key treatment for HIV/AIDS by a number of leading health associations globally.

ART involves a program of drugs which use inhibitors of viral enzymes to restrain the growth and reproduction of HIV. This decreases the amount of HIV within the body and helps to rebuild the immune system. 

However, HIV is constantly adapting as a virus and therefore drug-resistant strains begin to emerge, reducing the effectiveness of ART. Furthermore, the ineffectiveness may also be due to incorrect use of ART leading to drug-resistant HIV strains growing; for example, by failing to complete a course of ART, the virus is allowed to continue replication and so mutant drug-resistant strains may emerge and be selected. 

Results show that in some circumstances, as the number of cases using ART increases, so does the number of individuals who suffer from HIV (due to the emergence of drug resistance and not simply because of the longer life expectancy of a treated person). In conclusion, a larger focus on developing methods for reducing drug resistance may be more beneficial than increasing the number of patients who are treated using ART. 

This article is “Nested model reveals potential amplification of an HIV epidemic due to drug resistance” by Roberto A. Saenz and Sebastian Bonhoeffer (DOI 10.1016/j.epidem.2012.11.002) and appears in Epidemics published by Elsevier.